134 ANAPHYLAXIS, ALLERGY OR HYPERSENSITIVENESS 



bronchial spasm and later to paralysis of respiration, 1 lowered blood- 

 pressure, frequently cyanosis, an4 jdeath. Smaller intravenous injec- 

 tions are followed by the saijfce sympt$|Kis of excitement and respiratory 

 involvement, but to a lessfc degree, j Frequent micturition and fluid, 

 often bloody stools togetheV^ItK^reat prostration and dyspnea are 

 usually observed. The animal cannot stand and may die after several 

 hours, or eventually recover. 



Intraperitoneal injections elicit similar symptoms. Subcutaneous 

 injections rarely cause acute death; as a rule the animal has a febrile 

 reaction and repeated injections may be followed by the Arthus pheno- 

 menon. If the animal survives an anaphylactic reaction it is fre- 

 quently observed to be more refractory or even temporarily immune 

 to subsequent injections of the same protein. This refractory state 

 is called anti-anaphylaxis by Besredka and Steinhardt. 2 This period 

 of refractoriness is of variable duration. 



The postmortem appearance of guinea-pigs which have died from 

 the effects of acute anaphylaxis is usually striking and characteristic. 

 The lungs remain fully distended when the thorax is opened, the cut 

 surface is rather dry, and death appears to have resulted from 

 asphyxiation due to a tonic spasm of the bronchial musculature. 3 



Severe but non-fatal anaphylactic reactions are accompanied by a 

 lowering of the body temperature, lowered arterial pressure, leucopenia, 

 frequently with a temporary partial or complete loss of coagulability 

 of the blood, 4 followed by a secondary febrile rise of temperature and 

 a leukocytosis in which polymorphonuclear leukocytes and frequently 

 eosinophiles 5 are increased. Animals killed during the early acute 

 symptoms show but little distention of the lungs the lesions may 

 resemble those of an acute toxic gastro-enteritis. Ecchymoses and 

 ulcers may be found occasionally in the stomach and intestines, 

 together with parenchymatous degeneration of the liver and particu- 

 larly the kidneys, which may lead eventually to fatty degeneration of 

 these organs. 



The symptoms of anaphylaxis may be masked or even prevented by 

 the administration of certain drugs immediately before the reinjec- 

 tion of these atropin, chloral hydrate and similar narcotics are con- 

 sidered particularly efficient. 



1 Auer and Lewis, Jour. Am. Med. Assn., 1909, liii, 6; Biedl and Kraus, Wien. klin. 

 Wchnschr., 1910, 844. 



2 Ann. Inst. Past., 1907, xxi, 117, 384. 



3 Auer and Lewis, loc. cit. 



4 Biedl and Kraus, Wien. klin. Wchnschr., 1909, 363; Friedberger and Grober, Zeit. 

 f. Immunitatsforsch., 1911, ix, 216. 



B Moschowitz, New York Med. Jour., 1911, Ixxxxiii, 15. 



